Individual
AMOS JACOB ALUMNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
(562) 599-5235
Mailing address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
(562) 599-5235
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95200980
CA
164X00000X
Licensed Vocational Nurse
Primary
272095
CA
Other
Enumeration date
10/11/2017
Last updated
08/08/2019
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